Discussions around sex and sexual health are still taboo in most parts of the world. While sex educators, medical experts and sex-positive content-creators are broadening the space for sexual health talks and dialogues, we should aim to educate ourselves and others about the same. Through this article, we at Only My Health look forward to addressing one such sexual health problem in women, called dyspareunia, which translates to painful sex.
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What Is Dyspareunia?
According to Dr Gunjan Bhola, Associate Director & HOD Unit 2, Obstetrics & Gynaecology, Marengo Asia Hospitals, Sector 16, Faridabad (NCR), dyspareunia is the genital pain caused during or after a vaginal intercourse. The pain can be felt externally on the vulva or internally in the vagina, shares the doctor.
Common Causes of Painful Sex
Many factors can lead to a painful intercourse, ranging from physical to emotional reasons. Let's take a look at some of them.
Lack of lubrication
"Absence of foreplay or forceful penetration can lead to painful experience," says Dr Bhola. According to the Mayo Clinic, a decrease in the oestrogen levels after menopause or childbirth or during breastfeeding can also cause a lack of lubrication. In addition, some medications may impact pleasure and arousal, decreasing lubrication and leading to painful intercourse, explains the US health body.
Pelvic Inflammatory Disease (PID)
Pelvic Inflammatory Disease (PID) is an infection of the female reproductive system. One of the common symptoms includes discomfort or pain during sex that's felt deep inside the pelvis. Dr Bhola says, "Fungal and bacterial infections, such as urethritis, endometritis, salpingitis or cystitis, are common causes of Pelvic Inflammatory Disease (PID)."
"Endometrial implants on the pouch of Douglas, Uterosacral Ligaments (USLs) and rectovaginal septum can cause pain during intercourse," shares Dr Bhola. The pouch of Douglas is a part within the pelvis where the ovaries and fallopian tubes are situated, whereas Uterosacral Ligaments (USLs) comprise connective tissues that help support the uterus. Endometriosis can impact these deeply located organs leading to various problems, including painful intercourse. This type of endometriosis is also called "deeply infiltrating" or "Deeply Infiltrative Endometriosis" (DIE).
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Vaginismus refers to the involuntary spasm of vaginal muscles. Listing down the causes, Dr Bhola says that it can be a consequence of past sexual trauma, strict upbringing, and over-sensitive nerves at the vaginal entrance.
The Mayo Clinic describes vaginal atrophy as the "thinning, drying and inflammation of the vaginal walls." It occurs due to low oestrogen levels, leading to vaginal dryness, a significant concern in many women. According to Dr Bhola, this happens most often after menopause. Vaginal pain during the intercourse can be a common symptom of vaginal atrophy.
Tests & Treatments
Given that dyspareunia or painful intercourse can occur for several reasons, only a healthcare provider can confirm the cause of your illness or infection. A thorough medical check-up comprising a pelvic examination or an ultrasound can help in the diagnosis process. Depending on the grounds of the problem, your doctor will prescribe certain medications, recommend going for a desensitisation therapy, which includes vaginal relaxation exercises, or encourage you to get counselling or sex therapy. Remember, communicating and discussing your problems are the only ways to find a solution.